# SOUTHSIDE PHARMACY OF LORAIN INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southside Pharmacy of Lorain Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992105472
- **Authorized official:** NASER TAHER (OWNER)
- **Authorized official phone:** (440) 277-0655

## Contact information

- **Practice address:** 2811 FULTON RD, STE B, LORAIN, OH 44055-1638
- **Practice address phone:** (440) 277-0655
- **Practice address fax:** (440) 277-0651
- **Mailing address:** 2811 FULTON RD, STE B, LORAIN, OH 44055-1638
- **Mailing address phone:** (440) 277-0655
- **Mailing address fax:** (440) 277-0651

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 022447550 | OH | Yes |

## Other

- **Enumeration date:** 09/03/2014
- **Last updated:** 12/30/2014